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Objective Prenatal diagnosis of total anomalous pulmonary venous connection (TAPVC) is challenging even for experts.We sought to explore whether the use of spatiotemporal image correlation (STIC) can supply additional information with respect to conventional fetal echocardiography in the prenatal diagnosis of TAPVC.Methods Twenty-two cases diagnosed as TAPVC received fetal echocardiography examination from April 2009 to December 2013.Four-dimensional volumes from 16 cases of suspected TAPVC by conventional echocardiography at our hospital.Echocardiographic characteristics were compared with the results of postnatal work-up and pathology.Results Prenatal diagnosis was made at a mean gestational age of 26.6 (range 21 to 36) weeks.TAPVC was found in 22 cases by fetal echocardiography; four cases were isolated TAPVC, eighteen TAPVC had associated cardiac anomalies.Among them, nine cases were supracardiac types, five cases were infracardiac types and eight cases were intracardiac types.Twelve true positive cases of TAPVC were confirmed after birth or pathology.The fetal echocardiographic characteristics of 22 fetuses with TAPVC included absent insertions of pulmonary veins in the LA, increased distance between left atrium (LA) and descending aorta, presence of a confluence behind the left atrium, increased angle between left and right pulmonary veins.4D ultrasound with STIC clearly visualized the anomalous PV confluence and/or the draining vertical vein in all sixteen cases examined.Conclusion There are fetal echocardiographic characteristics of TAPVC.Conventional fetal echocardiography plays an important role in prenatal diagnosis of TAPVC.4D ultrasound with STIC should be proposed to identify abnormal venous drainage at the screening level, thus supplying additional information over that provided by 2D fetal echocardiography.